Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain.
Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
Eur J Intern Med. 2019 Feb;60:83-89. doi: 10.1016/j.ejim.2018.04.005. Epub 2018 Aug 9.
To analyze national trends in the rates of hospitalizations (all-cause and by principal discharge diagnosis) in total diabetic population of Spain.
We carried out a nation-wide population-based study of all diabetic patients hospitalized between 1997 and 2010. All-cause hospitalizations, hospitalizations by principal discharge diagnosis, mean age, Charlson Comorbidity Index, readmission rates and length of hospital stay were examined. Annual rates adjusted for age and sex were analyzed and trends were calculated.
Over 14-years-period, all-cause hospitalizations of diabetic patients increased significantly, with an average annual percentage change of 2.5 (95%CI: 1.5-3.5; P < 0.01). The greatest increase was observed in heart failure (5.4; 95%CI: 4.8-6.0; P < 0.001), followed by neoplasms (4.9; 95%CI: 3.6-5.8; P < 0.001), pneumonia (2.7; 95%CI: 2.0-4.0; P < 0.001), stroke (2.4; 95%CI: 1.6-3.4; P < 0.001), chronic obstructive pulmonary disease (2.0; 95%CI: 1.4-3.4; P < 0.001) and coronary artery disease (1.6; 95%CI: 1.1-2.3; P < 0.01). The adjusted number of all-cause hospitalizations of patients with diabetes per 100,000 inhabitants increased 2.6-fold. The increase in hospitalizations was significantly higher among patients ≥75 years old. Males experienced a greater increase in all-cause, neoplasm, heart failure, chronic obstructive pulmonary disease, and pneumonia hospitalizations (p < 0.01 for all). Hospitalized diabetic patients were progressively older and had more comorbidities, higher readmission rates and shorter hospital stays (p < 0.05 for all).
Hospitalizations of diabetic patients more than doubled in Spain during the study period. Heart failure and neoplasms experienced the greatest annual increases and remained the principal causes of hospitalization, probably associated with advanced age and comorbidities of hospitalized diabetics. Coronary and cerebrovascular diseases experienced a lower annual increase, suggesting an improvement in cardiovascular care in diabetes in Spain.
分析西班牙全部糖尿病患者住院率（全因住院率和主要出院诊断住院率）的国家趋势。
我们对 1997 年至 2010 年间所有住院的糖尿病患者进行了一项全国性的基于人群的研究。检查了全因住院率、主要出院诊断住院率、平均年龄、Charlson 合并症指数、再入院率和住院时间。分析了按年龄和性别调整的年度率，并计算了趋势。
在 14 年期间，糖尿病患者的全因住院率显著增加，平均年增长率为 2.5%（95%CI：1.5%-3.5%；P<0.01）。观察到心力衰竭（5.4%；95%CI：4.8%-6.0%；P<0.001）、肿瘤（4.9%；95%CI：3.6%-5.8%；P<0.001）、肺炎（2.7%；95%CI：2.0%-4.0%；P<0.001）、中风（2.4%；95%CI：1.6%-3.4%；P<0.001）、慢性阻塞性肺疾病（2.0%；95%CI：1.4%-3.4%；P<0.001）和冠状动脉疾病（1.6%；95%CI：1.1%-2.3%；P<0.01）的增加最为明显。每 10 万居民中糖尿病患者的全因住院人数增加了 2.6 倍。≥75 岁患者的住院人数增加更为显著。男性的全因住院率、肿瘤、心力衰竭、慢性阻塞性肺疾病和肺炎住院率均有显著增加（p<0.01 均有）。住院糖尿病患者的年龄逐渐增大，合并症更多，再入院率更高，住院时间更短（p<0.05 均有）。
研究期间，西班牙糖尿病患者的住院率增加了一倍以上。心力衰竭和肿瘤的年增长率最高，仍然是住院的主要原因，可能与住院糖尿病患者的高龄和合并症有关。冠心病和脑血管病的年增长率较低，表明西班牙在糖尿病心血管治疗方面有所改善。
